Single Ambulance Provider Sought In Everett

Currently when you call 9-1-1 for the Everett Fire department in a non-immediate-life-threatening event that requires a trip to the hospital, they call one of four ambulance companies that serve the city. Much like the tow companies, the ambulance services are on a rotation basis. If the first up doesn’t have an available unit they go to the next one on the list and so forth until one is available. This has led to delays and other issues, so last night the Everett Fire Department went before the city council with a plan to go out to bid for a single ambulance provider to serve the city’s needs.

We asked the city some questions about the plan and received the following responses from Emergency Medical Services Division Chief Tim Key…

1. Why EMS wants a single company instead of the rotation?

The city seeks to contract with a single ambulance provider in order to guarantee availability of ambulances for non-emergent (BLS) transport to the hospital. Under the current system, ambulance companies respond on a rotating basis when available, and there are frequently periods where no ambulances are available for transport. In those cases we are sometimes forced to utilize a medic unit to transport a non-emergency patient. This reduces the availability of that medic unit for true emergency responses. Each of the ambulance companies currently operating in Everett have contractual relationships with other healthcare institutions that are the mainstay of their business operations. Transporting Everett’s 911 patients to the hospital is something they do interspersed with their contractual duties. If faced with a choice, the ambulance company will always be compelled to comply with their contractual obligations rather than deferring to transporting 911 patients. We seek to have a similar contractual relationship to guarantee availability.

Additionally, the city has no arrangement with the ambulance providers that allows for Quality Assurance and Quality Improvement interactions. Nor are there provisions to define response times, equipment standards, training standards for ambulance employees or medical oversight by the Fire Department’s medical control physician.

A contractual relationship with one provider would define the relationship between the city and the contractor in each of those areas.

2. Have there been efficiency issues with the multiple providers?

Yes. SNOPAC dispatchers have to physically dial a telephone and speak with up to four ambulance dispatch centers to find an ambulance to respond to Everett calls for 911 transport. The RFP will seek a contractor that has instant electronic contact with SNOPAC, allowing dispatchers to simply ‘push a button’ to have an ambulance respond. This will result in significant efficiencies in the dispatch center which will translate to reduced time on scene by fire units waiting on ambulances.

A contract will also require the contractor to utilize a medical reporting system that is the same as, or easily interacts with, the fire department’s system. This will eliminate the need to prepare paper reports on the scene to hand to the ambulance crews. Patient data will now be transmitted electronically.

3. Is the $158,167.04 the amount budgeted for ambulance services and for what length of time?

The $158,167.04 is the amount that the ambulance contractor will pay to the city as an administrative fee to cover the cost of servicing the contract. This fee will offset the expense of .3 of an existing FTE to oversee operations and Quality Assurance of the contractor, as well as to offset costs of additional radios operating on SERS, as well as payments to SNOPAC. This type of fee is consistent with ambulance provider contracts in other municipalities such as Seattle and Tacoma.

4. Will this replace any medic transports?

No. We will continue to operate as we have in regard to BLS transport and ALS transport, only now we will have a contractual relationship rather than a relationship of convenience with our 911 BLS transport service provider.

The Everett City Council expects to get a look at the request for proposal next week and would have to approve any contract before the single ambulance provider agreement goes into effect.